Simmons 1

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Robert Simmons, 85, Clinton, Iowa

Karla Ice

Clinton, Iowa

3/30/2011

Karla Ice: Today we are interviewing Dr. Robert Simmons.

He lives in Clinton, Iowa. The location of the interview is his

home in Clinton. The date is March 30, 2011 at about 2:30.

I’m Karla Ice, and this is the first time that Dr. Simmons and

Simmons 2

I have met. Dr. Simmons, do we have your consent to be

interviewed?

Robert Simmons: Yes.

Ice: Very good. And, now may I ask you what your age is?

Simmons: I am 85 years of age.

Ice: Okay, and where were you born?

Simmons: Clinton, Iowa.

Ice: So, you’ve lived here all your life.

Simmons: All my life.

Ice: Just briefly, about your education and occupation?

Simmons: Okay. The only time I did not live in Clinton, Iowa

was the time I served in World War II, and the time I

attended college at The University of Chicago.

Ice: Okay. And, you took education to become…?

Simmons: A Doctor of Optometry. That was my degree.

Ice: Okay. And, you practiced for how many years?

Simmons: Well, approximately 50 years.

Simmons 3

Ice: Okay. And, did you have a solo practice? Were you in a

clinic without other…?

Simmons: No. I began as a solo practitioner, and gradually

took in various interns, and finally turned the practice over

to my son, who is also a Doctor of Optometry now, when he

graduated. Then, I continued to assist other optometrists in

the area, who had vacations, deaths in the family, different

things. I would sort of cover for them, so to speak. But, I

didn’t go as far as to prevent me from coming home at night.

So, it was more Dubuque, Cedar Rapids, Iowa City, Illinois,

Rock Island, because I also have an Illinois license. And,

the Davenport area. That was for the last, maybe, 20 years

that I did that.

Ice: Okay. Very interesting. And then, at what point did you

start to lose your vision, and how old were you at that time?

Simmons: I was 76 years of age. And so, this forced me to

be retired, because at that age I was still helping other

practitioners and such as that on a temporary basis, but, I

got to the point where I could no longer see. And so, that

ended my career.

Ice: And, what was the cause of your blindness?

Simmons: Macular degeneration. It started out in the one

eye as the dry macular degeneration, and within six months

it swiftly went to wet macular degeneration. So, I was

legally blind at that moment.

Ice: Okay. And, that affected both eyes?

Simmons 4

Simmons: Yes.

Ice: And, what kind of treatment was available at that time,

or what kind of treatment had you had, if any, for it?

Simmons: The first time there was one doctor that

specialized in retinal ophthalmology in Davenport, Iowa.

And, he confirmed my diagnosis; that it was macular

degeneration, as we were calling it in those days, macular

edema. And, the only thing that he could possibly do is

by…and there wasn’t even laser really in those times, was

just to say, “There’s really nothing we can possibly do for

you at this time.” But, surprisingly enough, six months later,

when I got the wet, I went to another retinal specialist that

had opened up in Davenport. I personally knew these men,

so this all helped. And, at that time, laser had been

developed, and they suggested perhaps doing this, as in wet

macular degeneration there are capillaries that bleed. It’s

almost like a blood blister on your finger, and the blood runs,

and of course it spoils the macula and the fovea of the eye.

So, by doing the laser they really didn’t correct anything. All

they did was stop the bleeding. In fact, there’s scar tissue.

And, I had 40 [Correction: 20] treatments in my right eye,

and 40 [Correction: 20] treatments in the left eye. And,

there was even a new technique called photo-dynamic

therapy, which is a cold laser. The hot laser, the trouble

was if you hit a spot, it would spread slightly. So, with the

cold laser, I mean, it was more pinpoint. The trouble is

though, this all occurred perhaps all five years too soon.

Nowadays, I’m going every three months to Iowa City

[clinic] to the Retinal Department, and they inject into my

Simmons 5

eye, by hypodermic needle, a drug called Avastin, which is a

drug that was originally for people with colon cancer to

prevent bleeding. And, I do have this to prevent further

bleeding, but they will invariably tell me every time if only

we could have done this, say two years ago or five years ago

on you, because there is no room for any improvement,

because of the scar tissue in the back of my eyes,

apparently. So, we’re currently just trying to keep it from

spreading on out.

Ice: Very interesting. And, naturally when you started

losing your vision it changed the way you need to do things

around the house, and so forth. Can you tell us about some

of those experiences?

Simmons: Yes, you just…you know there’s a difference

between the dry macular degeneration. Most people get this

at the beginning. If you notice, they lose visual acuity,

which means that surprisingly enough, they can probably

still drive a car, not as well as before. And, they can

possibly read with the use of a magnifying glass or

something like that. But, wet macular degeneration affects

the vision, so there’s a definite difference between visual

acuity, which is like the letter chart and things, and vision.

When you lose your vision, you are legally blind, and the

definition for legal blindness is if you cannot see better than

20/200 in the better eye. And, it’s just a definition I think

they came up with in, I think the 1930’s, if I’m not mistaken.

Something for legal purposes. I mean 20/200 in the better

eye is pretty bad. So, as a result, I mean, to do things, yes.

Around the house…I can no longer drive, I can no longer do

this or that, but my salvation was when a representative of

Simmons 6

the Iowa Department for the Blind by the name of Jonathan

Ice recommended I take a course in Des Moines, and I did,

and I learned a great deal from this course. I learned Braille,

and to this day I will mark soup cans and things, such as

this in the pantry. And, I can read what is in the can without

having to take it and put it under magnification. I also

learned cooking, and it happened to be around Thanksgiving

time, and I was assigned the assignment to make the

dressing for the turkey, and also stuff it and also roast it.

So, this was an experience. And, this was all done with

what they call sleep shades. They’re black sleep shades.

We were told to wear these for everything all the time we

were in Des Moines, except for just a lunch period. We

would get a little break for the lunch period to take them off

and go to lunch.

Another thing was, the thing I somewhat dreaded. We

were required to take every course that they offered, and

one course I hesitated about was woodworking. And, here it

was with all of these industrial power machines, and saws

and things, such as they had, and here I am completely

blinded. But, with the proper instructions and everything

like that, why my assignment was to make a picture frame

for my diploma, if I graduated. And, I believe there were

probably about a half a dozen in the class. Two were

women who sort of dropped out. I mean, you either have to

take every one of the courses they recommend, or else, you

know, you aren’t eligible to graduate, shall we say. And,

what else did we learn? We learned about the computer.

Right now things slip my mind what all we had. Oh, the big

thing was orientation. To take us outside and to have us go

downtown in Des Moines with heavily traffic intersections

and everything, and we had to go around the block with a

Simmons 7

white cane. And, to ask directions we had to stop and ask

strangers to tell us which way to go and everything. And, in

fact, after a couple of days, we had to go and get on a bus

and actually go to a grocery store and to pick out some of

the groceries for our so-called Thanksgiving dinner. And,

again, it was all vocal. We would still have the sleep shades

on and our white cane, but this forced us…I mean to learn

new techniques and to use other senses rather than the

visual sense, which was so important. But, I mean, we had

to use it by oral and other means, such as this. That was a

big turning point in my visual history was that week, or so,

that I did spend in Des Moines. And, I learned a great deal

and gained a lot of confidence. And, I still use most of that

stuff nowadays. Little things about like how to thread a

needle, how to tell different coins and bills. I invariably use

that every day.

Ice: And, how do you tell different bills apart, since they all

are the same size?

Simmons: Well, it’s on the sides. Quarters and dimes have

ridges, and pennies and nickels are smooth, and you can tell

from the sides from there. And, the paper bills it’s the way

that you fold them. And, this tells the difference, I mean, so

that you can positively tell the denominations of them.

Ice: So, you fold each denomination in a different way?

Simmons: In a little different way, that’s right.

Ice: And, you mentioned using Braille to mark soup cans.

So, then you Braille a piece of paper that you attach to…

Simmons 8

Simmons: A rubber band around it.

Ice: A rubber band around the can.

Simmons: Yeah.

Ice: Very good.

Simmons: I do not really have any…the instrument to print

the Braille, but, I mean, like I still read it and I can tell

what’s what, yeah.

Ice: Okay. The experience of preparing the turkey in Des

Moines. That sounds like that was a really interesting

experience. How did it all go?

Simmons: Well, you weren’t suppose to peak underneath

those blinders, which I didn’t, but how did it go? It was

really very, very interesting. We just stuffed the turkey and

everything such as this, and I purchased the turkey to start

with and brought it back to the Department. And, that was

my [assignment] to mix the dressing and everything, and

then I just stuffed it and put it in the roaster, and waited out

the time and carved it afterward.

Ice: So, you had to measure ingredients. How to you

measure things?

Simmons: Thank goodness they do have different

implements, which I use to this day. Different measuring

cups, and teaspoons and things such as this, which is a big

Simmons 9

help. Otherwise, again, it’s usually by touch as opposed to

visual.

Ice: And, you can feel if the cup and spoon is full or half full,

and…

Simmons: Right.

Ice: Okay. And, what about the way that you keep up with

the news, and do reading and things like that?

Simmons: Well, of course I do have the closed circuit

television, which helps me for detail, but otherwise I do have

my radio and I have the radio station from Augustana

College, and that’s WIV [WVIK] I believe, or something. Off-

hand, I can’t remember what it is. I can get it for you. And, I

listen to that while having breakfast, and it brings me up to

date on the latest news by the radio. It’s a wonderful

service. And, if I want more detail, then I do get, of course,

the morning paper, and I do love to work crossword puzzles,

and crypto quotes. And, of course, there I have to use my

CCTV for this. And, I do have…

15:00

Simmons: I became so dependent upon this instrument that

I now have three of them, so I don’t have to run upstairs and

downstairs, and to the lower level and different things. So, I

have them scattered. I still can’t get over…some people say

they are expensive. Yes, but, I mean, think of the

alternative. I mean, they just can’t read, and they can’t do a

lot of things, but I can do everything, you know, I can pay my

Simmons 10

own bills, write my own checks. I can read, I can work the

puzzles, and I can do everything with that instrument. It’s

really a godsend, and is money well-spent.

Ice: Yes. Yes, that’s amazing; you can even work

crossword puzzles?

Simmons: Yes, right. And, looking up in the dictionary,

which I also purchased at the Iowa Department for the Blind,

a large print dictionary, which I’ve just practically wore out

by now.

Ice: Okay. The way the CCTV works is that it has a

magnifying lens attached to it?

Simmons: Yes, and you can enlarge it by magnification.

And, matter of fact, it gives you different means. You can

have the black type on white. You can reverse it and have

white type on black background if that’s easier for you. You

can also get it in color, or get it in just plain black and white.

And, different things appear different in the papers and that,

and in magazines.

Ice: And, you mentioned the radio station that you listen to

through Augustana. And, that is from the news from

newspapers, or which newspaper?

Simmons: They read different newspapers, but I usually

catch it the first thing in the morning, with generalized

news, and it’s a wonderful program. I mean they actually

interview…have interviews with other people. And, I think it

must be a national, what…public broadcasting system or

Simmons 11

something that they’re connected to. So, it’s actually better

than the newspaper that we get.

Ice: Very interesting. And, then you also use computers?

Simmons: Um-hum.

Ice: And, was use of computers something you were already

doing before your blindness, or was that something you

learned after?

Simmons: Well, I started computers, yes, when they first

came out. And, of course, every year they changed

something different. So, in my lower level in the basement I

have the old Apple, the McIntosh and everything; if you know

anybody who would like some old ones. (Laughter) And so, I

sort of upgraded as they upgraded, but I took a course at the

junior college on computers, but again, it changed.

Nowadays, electronics have changed to digital. They’ve

changed things so much that it’s very difficult to keep up

with them; but now I use it definitely for emails, and to look

up different things, you know…recipes. And, since I’m a

care-giver I have to prepare things a little bit different. So,

they do have a couple programs. One is called ZoomText,

which I’d be lost without. And, you can magnify everything,

which I just likely have it on at all times. And, the other is

JAWS.

Ice: JAWS?

Simmons: Yes, JAWS, which talks back to me. So, when I’m

typing and things such as this, I mean, it will correct me. It

Simmons 12

will correct my spelling and my syntax and everything else.

So, I mean the two things, they’re wonderful programs they

have.

Ice: And, JAWS will read to you as you’re typing?

Simmons: Yes.

Ice: And, it will also read if you look up an Internet site, it

will read to you what’s on the screen?

Simmons: Yeah, exactly.

Ice: So, you get information that way.

Simmons: Right.

Ice: Very good. And, let’s see, back to maybe some of the

housekeeping things a little bit. I think there’s some

markings are put on things like appliances and thermostats

so you can…

Simmons: Yes. Mr. Ice has put on what they call Hy-Mark,

and it is something that hardens and I have it on my

microwave, of course, under the different numbers. I have it

on the oven on the stove top, on the dishwasher, and any

number of things; on the thermostat, so I can tell what the

temperature is in the room where I’m at. And, just by feel,

and it’s just a little dot. I know where everything is at.

Simmons 13

Ice: Okay, and you also have the role of being a care-taker

for your wife. Are there techniques you have used or

adaptations you have come up with in that role?

Simmons: I do all the cooking. I wash all the dishes. I

make the bed. My mother taught me a lot. And, I think the

big thing is in the cooking situation. There are things that I

wish I could do faster. I mean, I get things accomplished,

but I’m really slowed down. I’ve always been a person that

liked to do things rapidly. So, opening packages, perhaps

measuring and pouring liquids from a jar into a glass. Thank

goodness they taught me how to do that in Des Moines.

Otherwise, I’d spill all over the place.

Ice: And, how do you do that in order to keep from spilling?

Simmons: Keep one finger angled inside for milk. I use a

dark glass or a jar or a cup, so I can get some contrast.

Contrast is a big thing, right.

Ice: Okay. Can you think of any other adaptations or things

that you do differently?

Simmons: Grocery shopping. Yes, I walk every day and

between here and the nearest grocery store is probably

about a mile away. And, it’s probably through the busiest

intersections in the city. I do use my white cane, because

this seems to be a signal for the drivers rather than to take a

chance, because cars go so fast, and they’re on their cell

phones nowadays and everything else. But, that white cane

just seems to be a flag for oncoming motorists, and

everybody respects it very much so. And, they flag me on or

Simmons 14

honk as if to say, “Go on ahead.” And, at the grocery store, I

usually try to find someone, and most grocery stores are

very good about this, to find an employee to help you go

around and pick out the groceries. However, I do have

portable closed circuit TV’s, and so I can do pretty well with

these when the opportunity presents itself, and I do carry

those around with me.

Ice: Okay, that’s something new to me. How does the

portable CCTV…How big is that? How does that work?

Simmons: Oh, how can I describe it to you. It’s about, oh, 4

x 6 inches, yeah. I’ll show it to you when we get done.

Ice: Okay. Very interesting. And, what about

transportation. That’s often an issue.

Simmons: That is my big problem. When I got the wet

macular degeneration…on a Sunday afternoon I said to my

wife, I’m going to run up and get some cold slaw to eat with

our supper. And, I went to turn into the place and an

oncoming car was coming rapidly, and I just had to step on

the gas to get on their lawn, just to get out of the way. So,

when I got home, I gave the keys to my wife, and I said,

“That’s it. I do not want to hurt anybody, and I not only

wouldn’t want [them] to hurt me.” So, that was the end of

my driving.

For the next few years though, my wife still drove, and

it did help out a great deal. Now, she no longer drives, and

this is presenting a problem at the present time, even

though the city has a municipal transit authority. And, we

use this most all the time. It’s just $2. I don’t know how you

Simmons 15

can buy gasoline for $2 nowadays, but they will take us and

drop us off at a doctor’s office, at the grocery store or

some[where] if we want to. But, like I say, I usually walk to

that. But, if I’m carrying heavy things like gallons of milk

and canned goods, which can get pretty heavy, then I would

probably use some of that. I’m also in a coffee group. And,

the men are wonderful. They pick me up in the morning and

on the way home they will ask if there’s any errands I have

to do before I go home. So, I hate to take advantage of

them, but I do stop and pick up prescriptions and maybe that

gallon of milk, which is heavy to carry or something. And,

also, my wife’s sister who has recently moved back into the

area, even though she’s busy with her volunteer work and

different activities, she’s pretty good about taking us

around. And, I do have a woman that comes in to clean

every two weeks, to help me clean, like, the bathrooms and

the kitchen. And, she’s very good about, you know, taking

me around to do errands. But, this has presented a problem

that no one in the family does drive. You don’t know how

much you miss that, but I take buses, you know, the bus

service is very good. So, I have to do a little walking to

catch it, but no problem, at least I can get there.

Ice: Okay, very good. And, you mentioned your coffee

group. Is that something you’ve belonged to for a long time?

Simmons: Oh, for some time, yes. Even when in the days

when I could see who was there. Right. Yes, they’re just a

wonderful group. At our age we loose some and get a few

new ones and things such as that, but we do solve all of the

problems of the world it seems like every morning.

Simmons 16

Ice: So, you get together every morning?

Simmons: Five days a week. And, it’s a chance to laugh and

to needle each other, but this is what we need; rather than

be so serious all of the time.

Ice: About how many people are in the group?

Simmons: Well, we usually keep it at twelve, but now we’re

down to about six, but we’re all very faithful about the whole

thing, about coming every morning. At twelve people you

usually have two or three conversations going at once. With

six people, you have one conversation, which is sort of nice;

people join in.

Ice: What about other community activities or groups that

you go to or belong to?

Simmons: I am in a group called Citizens [Correction:

Seniors] Versus Crime, which is headed by the Sheriff’s

Department. And, I was asked to join that, and we do meet

once a month. We also have our VIP (Visually Impaired

People), our support group which also meets once a month.

And, what else…Well, I play golf, I mean somebody has to

tell me which way the ball goes and which tree it’s gone

behind or something, but at least it gets me outside into the

fresh air; and bowling, about the same thing. I do play

cards. We play bridge probably about once a week. I have

very, very large cards that I can see. And, people…the other

players are pretty good, you know. Occasionally you’ll make

mistakes and things with the cards you can’t see, but they

accept all of this nowadays. So, but as far as other

Simmons 17

volunteer groups, there’s probably some that I just can’t

think of right now.

Ice: It sounds like you keep active and keep busy.

Simmons: I try to keep active.

Ice: Yes. Do you have any other comments about life with

your loss of vision, or the adaptations you’ve made? Did you

have any other more comments about the macular

degeneration? I should mention here that he prepared a

written document that gives a very understandable

explanation of macular degeneration and the difference

between wet and dry, and the treatments for that. And so,

that will be submitted along with this oral interview.

Simmons: Yeah. That’s one other thing that I do, and

Jonathan sort of uses me, I mean. People who are just

developing macular degeneration. I mean, there’s an area

there where people become quite depressed, and he will

often times, and other people also do this, if they’ll know

somebody. They’ll ask me if I wouldn’t talk to them about

the situation. I mean, to assure them that they’re never

going to go blind, as we know it. Legally blind, yes, but we

still have our peripheral vision and we can still get around.

30:00

Simmons: I try to encourage them, because as I said in that

report, macular degeneration has a way of pushing every

button you have, and it can bring out anxiety and grief, and

Simmons 18

depression and all of the bad things. So, it’s something you

have to overcome.

Ice: And, it certainly sounds like you have done a good job

of overcoming all of those things. You did mention a little

bit about the quirkiness of having macular degeneration,

where you can see something insignificant out on the edge.

Simmons: Yes. People cannot understand this, but I will

see something on the floor with my peripheral vision, and I

will, you know, pick it up and people will invariably…if it’s

happened once, it’s happened dozens of times…they’ll say,

“How can you see that?” Well, I can’t see straight ahead, I

can’t even see who I’m speaking to as a rule, because I

cannot see faces, but that peripheral vision, it’s just

something with a contrast. I can sort of pick it up. It’s very,

very blurred, but there it is.

Ice: Okay, that’s an interesting sidelight. Do you have any

other comments? Otherwise, I think we’ll conclude the

interview.

Simmons: Okay. I’ll probably think of something and we

can…

Ice: Sure, and that can always be added later. Well, thank

you so much for your time and your contribution.

Simmons: Well, you’re welcome.

31:41

(End of Recording 1)

Simmons 19

(Beginning of Recording 2)

Ice: This is an extension of the interview with Dr. Bob

Simmons. We’re going to be talking about some of the

optical aids that are available to people these days.

Simmons: There’s always something that comes out, and

it’s always a very helpful thing. As you know, macular

degeneration…there’s no cure for it. And, as a result, I

mean, we are depending more and more daily, but with

electronic aids with the digital age we’re in. I mean, they’re

coming out with some wonderful different things. And, also,

with my background, my profession and my son’s

background, we have closeness to different companies and

different things. And, we keep up on these things about low

vision. So, if you want me to I’m going to bring out some of

the more important things perhaps.

Ice: Sure.

Simmons: And, bring it to people’s attention. Because it’s

something that a lot of people don’t realize, but, I mean,

rehabilitation and low vision is very important. It’s a

profession in itself, really, but people just don’t know that

much about it or what to do or how to go about it. And,

that’s where we’ve been a little bit lax in bringing this

information to the public.

Ice: Do you want to mention some of those things now, or

would you prefer to write it up.

Simmons 20

Simmons: Let me write it up, yeah.

Ice: Okay, very good.

Simmons: Because invariably, I’d probably forget something

important.

Ice: Okay. Thank you very much.

1:50

(End of Recording 2)

Jo Ann Slayton

04/30/2011.

[After the interview, Mr. Simmons submitted information on

macular degeneration and devices he wished to include in

his transcript. The information is as follows:

I was born in 1925 and was an intensely visual person,

who enjoyed an active lifestyle. My life occupation was as a

Doctor of Optometry. I practiced my profession for fifty

years.

In 2001, at the age of seventy-six, I developed macular

degeneration in one eye. For six months I was fine, until the

loss was followed swiftly by the loss of my vision in my

other eye from full-blown wet macular degeneration. Laser

treatments could not stop the progression of the condition,

and I was forced to give up driving, a significant

disadvantage. My low vision was a tremendous blow to me.

I struggled with managing my business affairs, and struggled

with depression.

Simmons 21

Today, at eighty-five, I am into late stage macular

degeneration, with 20/800 in one eye, and 20/400 in the

other. Yet my outlook is brighter than it was several years

ago. Since I am still alive and healthy, I believe I am meant

to be happy, and so I’ve decided to do so. I am a full-time

care-giver to my wife, and we live independently. I take long

walks in the neighborhood, regularly crossing intersections

of every size, shop for groceries, and use the local buses. I

volunteer at charities, helping other seniors. I bowled and

play cards, attend a morning coffee group, dine out often

and write my own checks. I particularly enjoy books on

tape, and have become an avid listener. I read more now

with my ears than I used to with my eyes.

What enables me to survive, to be happy? How do I

manage to meet the enormous challenge of vision loss,

combined with being a full-time care-giver? How did I

manage to turn a larger-than-life lemon into lemonade? I do

have some important advantages.

First, as an optometrist, I knew about optics and how

magnifiers work, and could experiment with different

models, finding the right one to maximize my sight. Just as I

used to solve vision problems through careful testing.

Secondly, I am quite straightforward about my vision loss,

and I do not hesitate to ask acquaintances to identify

themselves or waiters to help with menus. I believe low

vision is nothing to be embarrassed about. Finally, my son is

a Doctor of Optometry and has access to rehabilitation

services, a support group, and a full range of optical aids.

But what about the1.5 million other Americans who have

vision loss from macular degeneration and may not have

these advantages? There may not be another medical

condition in this country that is so common, that impacts

Simmons 22

daily living as profoundly, and yet is so little publicized.

Many with macular degeneration are frustrated that there

aren’t better treatments, and they want to know exactly

what is known about macular degeneration, and the status

of current research.

Macular degeneration does not blind. It leaves

peripheral vision intact, and this remaining vision is a saving

grace. You can learn to maximize your remaining sight

through optic aids and rehabilitation, and it will take you a

long way to maintaining a lifestyle you enjoy.

What is ARMD?

Age-Related Macular Degeneration is the leading cause of

adult vision loss in the United States. It affects more people

than all of the better known eye diseases combined;

glaucoma, cataracts, and diabetic retinopathy. One out of

twenty-five Americans over sixty-five suffers significant

vision loss from advanced macular degeneration. Clearly, if

you have ARMD, you are not alone.

Macular Degeneration dismantles central vision painlessly

and silently, leaving peripheral vision intact. As a result,

people with advanced macular degeneration do not feel any

change in their eyes, nor do they appear any different to

their friends or family, but their experience of the world and

of their own capacities change radically. Because macular

degeneration leaves peripheral vision intact, people with

ARMD can see whatever rests at the edges of their vision,

but cannot see clearly whatever they look at directly. It

takes away what we most want to see, and leaves visible

what appears to be irrelevant. You can’t read or drive or

recognize faces, but you can pick up a piece of thread off

the carpet, but that is not high on my list of activities.

Simmons 23

Why has macular degeneration been a big secret?

Unlike cataracts, which can be easily seen, or glaucoma,

which can easily be measured, macular degeneration is

more difficult to analyze and to treat, so it wound up a bit

lower on the research priority list. Secondly, declining

vision was simply accepted as the result of “ just growing

old”. People now days are living longer and more healthy

than their parents and grandparents; a sixty-five-year-old

may have twenty to forty more years of reading,

entertaining, traveling, and sports ahead of them, and may

not be ready to retire. This is why insurance companies do

not cover visual aids or therapy for low vision. The truth is

that macular degeneration is complicated: there is no easy

answer to its cure.

Macular Degeneration isn’t just about your eyes.

Most people say that they would rather lose a limb than an

eye. Surveys have shown that vision loss is among the most

feared afflictions, among with cancer. Why? Because

eyesight affects every aspect of life: mobility, physical

activity, communication, appearance, psychological health

and so on. Macular Degeneration is tailor-made to push

every button we have. It can raise feelings of grief,

helplessness, depression, fear, anxiety and anger.

Macular Degeneration explained.

Our eyes are like cameras. Light enters our eye through the

pupil, is focused by the lens, and falls on the retina at the

back of our eye. The retina picks up light and converts into

nerve signals. The retina sends the nerve signals through

Simmons 24

the optic nerve to the brain, which “develops” into the

images we actually see.

The Macula

The retina has two types of photoreceptor cells that convert

light into electrical messages for the optic nerve to

transmit: rod cells and cone cells, so named for their

shapes. There are many more rod cells that are responsible

for peripheral vision. Cone cells are concentrated in the

center of the retina – and are responsible for central vision,

color perception and sharp images (acute vision). The

capacity of cones to distinguish detail is one hundred times

greater than rods. We need them to tell the difference

between forest green and black, and to see precise detail.

The fovea is the very center of the macula, and contains

only cone cells. This tiny area is responsible for so much of

what we see. In macular degeneration, the rods and cones

in the macula begin to die, reducing the number of cells to

transmit visual signals to the brain. In addition to the rods

and cones, there are three other key players (membranes) in

macular degeneration. They supply a delivery line for

nutrition (oxygen) to the macula and whisking away waste.

Dying from lack of oxygen and clogged with refuse is what

causes macular degeneration.

Two types of ARMD

There are two types of macular degeneration, commonly

called dry and wet. All cases are thought to start with the

dry form. Between 10 percent and 15 percent of the people

who show signs of dry macular degeneration eventually

develop the wet form. Dry macular degeneration develops

slowly and silently. They gradually lose visual acuity, while

Simmons 25

wet loses vision. Dry type can usually continue to drive and

read, but blurred.

Wet macular degeneration

Wet ARMD is called “wet” because it is characterized by

abnormal, leaky blood vessels that grow underneath the

retina in the choroid layer. Ninety percent of the people who

develop wet macular degeneration become legally blind.

Risk Factors of acquiring ARMD

Sex: Women over the age of seventy-five have twice the

incidence of early macular degeneration and over seven

times the incidence of developing wet macular

degeneration.

Race: Caucasian, rarely seen in African-Americans

Genetic factor: Familial affect

Blue and light colored eyes

Cigarette smoking

Cardio-Vascular disease

UV exposure

Antioxidants and Vitamins for delaying ARMD:

Vitamins A, C, E

Zinc

Dark leafy vegetables

Lutein

Zeaxanthin

Low fat diet

Beta-carotene

Selenium

Copper

O.T.C. vitamins:

Simmons 26

Bausch & Lomb Preserv-a-vision

I-Caps

Making Things Bigger

There are sophisticated devices constantly being made

available to us to help in daily living.

Magnifiers are fantastic tools. But magnifiers are also

tricky. Thoughtful people give people with low vision a

perfectly good magnifier as a gift, and it doesn’t work at all.

Technically, magnifiers always work. Their job is to magnify

and they always do, but magnifiers are made in different

strengths and styles, and they magnify clearly only when

they are held at the correct distance. You have to choose

magnifiers with the right strength (power) for your visual

acuity, you have to choose the right styles for your needs,

you have to use your magnifier correctly, and you have to

have adequate lighting. Since magnifiers are rarely sold

with instructions or users manuals, it’s very easy to get the

wrong one if you’re choosing on your own. And it’s true that

the wrong magnifier will not work for you.

There are two broad categories of magnifiers:

magnifiers for seeing up close, and telescopes for seeing

things at a distance. To get the right one you need to know

what you want it to do, and what the magnifier you are

considering actually does.

There are five types of magnifiers for close viewing. 1.

Hand-held magnifiers; 2.Magnifiers in non-adjustable holders

that sit directly on the page; 3.Magnifiers on an adjustable

support (goose neck); 4.Electronic magnifiers (closed circuit

television, CCTV), computer software and hardware; and

5.Magnifiers that fit on you nose or hear.]